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Published on: January 14, 2014
Rapid growth of primary cerebral fibrosarcoma with conversion to glioblastoma at second recurrence
Amos Olufemi Adeleye1, Yakov Fellig, Felix Umansky
1Department of Neurosurgery, Hadassah - Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel.
Abstract:
We present a case of de novo fibrosarcoma in a 43-year-old male, with MRI documented evolution from a 5 mm hyperintense area to 5 cm tumor mass in a 12-month period. The diagnosis of low-grade fibrosarcoma was established by three experienced neuropathologists. The patient underwent gross total resection with adjuvant fractionated conformal radiotherapy. Following first recurrence 3 months later, the patient was reoperated and stereotactic radiosurgery of a residual tumor was performed thereafter. The pathological diagnosis was similar, but with additional extensive radiation effects. Six months later the patient underwent aggressive surgical resection for second recurrence. The pathological diagnosis was WHO grade IV glioblastoma. The etiology of this highly unusual progression from primary mesenchymal neoplasm to high-grade glioma is discussed.
Insights
A rare case of fibrosarcoma transformed into glioblastoma is presented. This unusual progression highlights the complex behavior of brain tumors and the need for further research into their etiology.
Area of Science:
- Neuro-oncology
- Pathology
- Radiology
Background:
- Fibrosarcoma is a rare malignant mesenchymal tumor.
- Glioblastoma is a WHO grade IV primary brain tumor.
Observation:
- A 43-year-old male presented with a de novo fibrosarcoma.
- MRI showed rapid tumor growth over 12 months.
- Initial diagnosis was low-grade fibrosarcoma confirmed by neuropathologists.
Findings:
- The patient underwent resection and radiotherapy.
- Recurrence led to reoperation and radiosurgery.
- Second recurrence revealed a WHO grade IV glioblastoma.
- Pathology showed extensive radiation effects alongside tumor progression.
Implications:
- This case presents a highly unusual malignant transformation.
- Discusses the potential etiology of mesenchymal neoplasm to high-grade glioma progression.
- Highlights the importance of vigilant monitoring and re-evaluation of brain tumor diagnoses.
